May 10, 1993

Hypermagnesemic Pseudocoma

Author Affiliations

From the Departments of Neurology (Drs Rizzo and Fisher) and Medicine (Dr Lock), The Medical Center of Central Massachusetts and University of Massachusetts Medical School, Worcester.

Arch Intern Med. 1993;153(9):1130-1132. doi:10.1001/archinte.1993.00410090072009

We treated a case of iatrogenic hypermagnesemia that clinically mimicked a central brain-stem herniation syndrome. Hypermagnesemia (magnesium level, 9.85 mmol/L [24 mg/dL]) can cause parasympathetic blockade, inducing fixed and dilated pupils, in addition to neuromuscular blockade. Extreme hypermagnesemia can therefore mimic a midbrain syndrome and cause a pseudocomatose state.

(Arch Intern Med. 1993;153:1130-1132)